Dr. Dipesh Parmar outlines two key procedures you can follow when doing an interproximal wall construction.
When restoring a patient's tooth, it is vital to reconstruct the interproximal wall correctly. After all, it will determine the overall shape of the restoration.
When looking to build up interproximal areas, there are two approaches you can take:
- Immediate approach – It is done immediately after the palatal coating and before the dentin consolidates.
- Delayed approach – It is done after the palatal shell and after the dentin has consolidated. The interproximal areas are restored when the final enamel mass is made.
Decomposition – Immediate Approach
After creating the palatal shell, insert an interproximal matrix and use the help of a wedge to stabilize it. Then, obtain a small increment of resin and insert it into the interproximal area. Sculpt a composite model to form a suitable shell and light cure the composite against the interproximal matrix. Following this method, once the matrix is removed, you will have a palatal shell along with an adjacent interproximal shell.
Decomposition – Delayed Approach
The delayed technique is used by most dentists. After completing the palatal shell and dentin build-up, insert an acetate matrix and secure it with a wooden wedge. Apply the final increment of resin (enamel mass) and, as you model it on the facial surface, pack the interproximal composite. Finally, apply a small amount of modeling resin to the Mylar strip and, using the Mylar pull through technique, pull the strip from buccal to palatal. In doing so, you will essentially pull the composite to form the interproximal wall.
Source: enlightensmiles.com
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